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Biomedical subjects

A P Savchenko

Publications and source records attributed to A P Savchenko.

At least 19 recordsLinked to original sources
PubMed1995

[Predictors of coronary artery restenosis in IHD patients after transluminal balloon coronary angioplasty].

To determine clinical and angiographic predictors of restenosis after successful PTCA, we analysed the data on 63 patients (68 stenoses) who had undergone repeat coronary angiography during the first eight months after successful PTCA. The overall restenosis rate was 42.6%. Four clinical and angiographic factors were associated with high risk of restenosis. Residual stenosis > or = 25% was the strongest predictor of restenosis (p = 0.002). Among other factors presence of unstable angina, complicated lesion morphology and absence of intimal dissection had equal value of significance (p = 0.02 in all the cases).

Angioplasty, Balloon, Coronary↗
PubMed1994

[The results of catheterization and the x-ray angiographic assessment of cardiac contractility and volume in primary pulmonary hypertension].

To ascertain the role of invasive investigations in the diagnosis of primary pulmonary hypertension (PPH), 12 PPH patients underwent catheterization of the left and right heart compartments, contrast right and left ventriculography and oximetry. Compared to control values, the patients had high pressure in the pulmonary artery and right ventricle. Some of them exhibited elevated pressure in the right atrium. Pulmonary artery wedge pressure, left ventricular end-diastolic and systolic, diastolic pressure in the aorta did not differ significantly from those in the controls. Right and left ventriculography revealed an increase in the end-systolic and end-diastolic volumes of the right ventricle which diminished its stroke index and ejection fraction. The latter two were reduced in the left ventricle also. Because the procedure was well tolerated by the patients, it is recommended for PPH diagnosis and follow-up.

Adult↗
PubMed1993

[Changes in the blood lipoprotein and apolipoprotein spectrum and the state of coronary channel in patients with unstable angina pectoris: a follow-up].

The study was undertaken to examine 34 male patients with unstable angina pectoris who underwent coronary angiography (in the period of instability and at rehospitalization) and study of protein and lipid parameters in their plasma. During a follow-up (mean 33.9-2.2 months), the patients were divided into 2 groups according to the changes occurring in the coronary bed. These included: (1) patients with progressive atherosclerotic changes and (2) those with stabilization of the process. Changes in the lipid profile in patients with unstable angina were found to appear as profound atherogenic shifts in the spectrum of lipoproteins and apolipoproteins, which suggests that coronary atherosclerosis is progressive in the late period.

Adult↗
PubMed1993

[Decreased tonus of the epicardial coronary arteries in patients with dilated cardiomyopathy].

The tone of coronary artery (CA) was evaluated in 26 patients with dilated cardiomyopathy (DCMP) and 20 patients with atypical chest pain, intact CA, and normal left ventricular contractility served as controls. All the patients underwent selective polyviewed coronarography, left and right ventriculography. The configurations of the great CA were examined by a computer which calculated their mean diameter in diastole (Dd) and systole (Ds), their difference (d) and the elasticity index (EI) by the formula: d/Dsx 100%. Twelve patients with DCMP and 10 control patients had repeated left coronary contrasting after intracoronary injection of nitroglycerin, 150 mg, they authors calculated the baseline Dd (Dd1), Dd after nitroglycerin (Dd2), the degree of nitroglycerin-induced CA dilation. Ds was found to be greater than Dd in the two groups. The mean CA diameter was significantly more in DCMP patients who had lower D and EI. Intracoronary nitroglycerin injection caused a less marked increase ion the Dd of the anterior descending CA in DCMP patients. Thus, the computer-aided analysis of coronarograms and nitroglycerin test allowed one to quantitatively determined the decreases in CA in DCMP.

Biopsy↗
PubMed1993

[Left ventricular function in patients with ischemic heart disease at the moment of acute myocardial ischemia induced by transesophageal cardiac electrostimulation].

Repeat transvenous multiphase left ventriculography was performed in 14 patients with coronary stenosis diagnosed by clinical and angiographic findings. The procedure was conducted before and in the course of transesophageal pacing. The latter provoked acute myocardial ischemia responsible for a wide range of left ventricular dysfunctions which are analyzed in the paper in terms of cardiomanometry parameters, cardiocycle energetic balance, diastolic function and local motions of the camera walls.

Acute Disease↗
PubMed1993

[Left ventricular function in patients with arterial hypertension during the performance of acute drug tests with captopril and nifedipine].

An examination was made of 22 hypertensive patients with clinical and echoCG symptoms of left ventricular hypertrophy. All the patients underwent coronary angiography, transvenous multiphase left ventriculography and acute captopril (11 patients), nifedipine (11 patients) tests. A single oral 25 mg dose of captopril increased energetic efficacy of cardiocycle, restored diastolic function of the left ventricle, aroused myocardial contractility.

Adult↗
PubMed1993

[Left ventricular function in patients with arterial hypertension and myocardial hypertrophy based on the data of multiphasic ventriculography].

The study included 39 hypertensive subjects with clinical echocardiographic evidence of left ventricular hypertrophy. All the patients were subjected to coronary angiography and transvenous multiple-phase left ventriculography. Early subclinical signs of left ventricular dysfunction in hypertensive patients have been defined. They concern energetic efficacy of the cardiac cycle, left ventricular diastolic function, myocardial asynchronism. It is noted that the above dysfunction was recorded in cases where standard two-image analysis provides normal values.

Adult↗
PubMed1993

[The clinical characteristics of ischemic heart disease in patients with arterial hypertension of different origins].

To study the clinical picture of coronary heart disease with concomitant arterial hypertension of various genesis, 172 patients were examined, out of them the cause of arterial hypertension was hypertensive disease in 54, chronic pyelonephritis in 40, chronic glomerulonephritis in 37, and stenotic atherosclerosis of renal arteries in 29, endocrine disease in 12 patients. The patients were divided into 2 groups: (1) 148 with stenotic atherosclerosis of coronary arteries and (2) 24 patients with intact coronary arteries. Comparison of these patient groups revealed no clear-cut correlation between the age and the detection of exercise-induced angina, as well as the duration of arterial hypertension. There was no correlation between the detection of the anginal syndrome and ECG changes. The incidence of the anginal syndrome was 62.2% in Group 1 and 47.7% in Group 2. It was established that the detection of the anginal syndrome correlated well with the severity of left ventricular hypertrophy and values of blood pressure, despite nosological entities.

Adult↗
PubMed1992

[The function of the collateral bed in patients with ischemic heart disease and isolated occlusion of the anterior descending branch of the left coronary artery].

To study the collateral bed, 39 coronary heart disease patients with isolated occlusion of the anterior descending artery without a history of large-focal myocardial infarction were examined. All the patients were subjected to coronary angiography and left ventriculography. Based on an analysis of left ventricular myocardial contractility, the patients were distributed into 2 groups. The first group included 16 patients without disorders of local contractility of the left ventricular myocardium, the second one 23 patients with derangement of local contractility of the left ventricular myocardium. The conclusion is made that in patients suffering from stable angina pectoris with isolated occlusion of the anterior descending artery without a history of large-focal myocardial infarction, exclusively intersystemic collateralization of the vessel via the conal artery (or the conal branch of the right coronary artery) is most favourable from the standpoint of the maintenance of myocardial contractility.

Collateral Circulation↗
PubMed1992

[Left ventricular function in patients with ischemic heart disease and "critical" stenosis of one coronary artery. The data from multiphasic ventriculography].

As many as 38 patients with the clinical and angiographic signs of "critical" stenosing of one coronary artery were examined. All the patients underwent coronary angiography and transvenous multiphase left ventriculography. The authors defined a complex of fairly early, "preclinical" signs of myocardial ischemia, pertaining to the energetic effectiveness of the cardiocycle, diastolic function of the left ventricle and indices of the local movement of chamber walls. It is important that these signs are recordable in minimal, clinically undetectable myocardial ischemia characterized by the lack of anginous pain, no changes in the ECG, and when the two-picture analysis, commonly used in clinical practice, provides normal results.

Adult↗
PubMed1992

[Prognostic significance of various qualitative and quantitative indicators of coronary angiography in patients with unstable stenocardia].

The coronary bed was qualitatively and quantitatively examined in 41 patients with unstable angina pectoris. The patients were divided into two groups: (1) those with uncomplicated angina and (2) those with complicated angina in relation of follow-up (mean 3.1 +/- 0.8 years) findings. In patients with a poor coronary heart disease outcome a symptom-related lesion was more frequently located mainly in the left coronary trunk during clinical manifestations of unstable angina pectoris, along with more severe overall lesion in the coronary bed. They had also higher incidence rates of complicated lesions and higher values of three quantitative parameters (stenosis extent, the mean and proper diameters of a stenotic segment in the symptom-related vessel) determined by semiautomatic stenosis configuration analysis.

Adult↗
PubMed1991

[State of the coronary arteries and function of the left heart ventricle in patients with ischemic heart disease with silent episodes of myocardial ischemia].

The results of multiviewed coronary angiography with left ventriculography were compared in 36 patients with coronary heart disease concurrent with Functional Classes II-IV stable angina pectoris, who had had frequent episodes of silent myocardial ischemia (SMI), as evidenced by Holter monitoring, and in 23 patients with coronary heart disease in the presence of Functional Classes II-IV stable angina pectoris without SMI episodes. In patients with SMI, the changes in coronary arteries were found to have some features: the extension of an atherosclerotic process (common lesion of all three major arteries), its frequent site in the main trunk of the left coronary artery, high collateralization in the diseased vascular channels, and great extent of stenoses. There were no differences between the groups in the major functional parameters of the left ventricular myocardium.

Adult↗
PubMed1991

[The effects of delayed transluminal balloon coronary angioplasty in myocardial infarct patients with early thrombolytic recanalization of the coronary artery: the results of dynamic quantitative angiography].

As many as 71 patients with the developing large-focal myocardial infarction (MI) were entered into the study. The purpose was to examine the dynamics of the status of the coronary arteries and left ventricular function in MI patients with early recanalization of the infarct-related artery (IRA) as a result of thrombolytic therapy (TLT) and delayed transluminal coronary angioplasty (TCA). Coronary arteriography and left ventriculography were provided 3 times to all the patients: within the first 4 hours of the disease (in combination with TLT), on days 4-6 of the disease (in combination with TCA of the IRA), and after 6 months of observation. It is concluded that the combined use in MI patients of coronary thrombolysis within the first 4 hours of the disease and delayed TCA (on days 4-6 of the disease) ensure steady recovery of IRA patency, with an insignificant residual stenosis of the artery. At the same time the patients demonstrated improvement of local contractility of the deranged compartment of the left ventricle by the 6th month of observation. Restenosis of the recanalized IRA that occurs during 6 months of observation after the interventions performed does not affect the recovery of left ventricular function.

Angioplasty, Balloon, Coronary↗
PubMed1991

[The ST-segment-dependent indices of patients with left ventricular hypertrophy and coronary failure].

As many as 40 men suffering from essential hypertension (EH) and left ventricular hypertrophy (LVH) or hypertrophic cardiomyopathy (HCMP) were examined. All the patients exercised on a treadmill according to the Cornell protocol taking into consideration the ST/HR slope and the ST/HR index, underwent echocardiography with measurements of the left ventricular mass (LVM), and coronary ventriculography. Coronary insufficiency was revealed in all the patients. Of these, 11 patients suffered from it due to associated EH and coronary heart disease (CHD), 31 had relative coronary insufficiency in the presence of associated EH and LVH phenomena with no stenosis of coronary vessels, and 7 patients showed up relative coronary insufficiency in the presence of HCMP. The ST/HR slope and the ST/HR index correlated well with the LVM and the asymmetry index of the left ventricle but in patients with associated relative coronary insufficiency and EH. In patients with associated EH and CHD, the ST-dependent parameters correlated well neither with the degree of atherosclerosis spreading nor with the LVM. This may indicate that both factors influence the gravity of coronary insufficiency at a time. In case a patient suffering from associated EH and coronary insufficiency phenomena has the ST/HR slope greater than or equal to greater than or equal to 4.5 microV/stroke/min and/or the ST/HR index greater than or equal to greater than or equal to 2.5 microV/stroke/min, it is more likely that myocardial ischemia is provoked by concomitant atherosclerosis of coronary arteries (sensitivity 28%, specificity 71%).

Adult↗